A modified Steiner's analysis that does not require radiographic exposure of the cranial base

Can modifying shielding, field of view, and exposure settings make the effective dose of a cone-beam computed tomography comparable to traditional radiographs used for orthodontic diagnosis?

OBJECTIVES

To analyze the effect of changes in exposure settings, field of view (FOV), and shielding on radiation to an adult and child phantom from cone-beam computed tomography (CBCT) imaging compared to panoramic and lateral cephalometric radiographs.

MATERIALS AND METHODS

The effective dose to an adult and child anthropomorphic phantom by the CS 9300 using various scan protocols was recorded. Absorbed radiation was measured with optically stimulated luminescence dosimeters and effective dose calculated using 2007 International Commission on Radiological Protection tissue weighting factors. Scan protocols included different FOVs, voxel sizes, and standard versus low-dose protocols. Radiation shielding was used when it did not interfere with FOV. Panoramic and lateral cephalometric radiographs were taken with the Orthophos SL.

RESULTS

Even with shielding, smaller FOVs, and increased voxel sizes, the effective dose of standard CBCT scans was higher than panoramic and lateral cephalometric radiographs. A shielded limited FOV standard scan combined with a lateral cephalometric radiograph resulted in a lower dose (P < .001) than a full FOV standard scan. Low-dose shielded scans resulted in significant dose reductions to the adult (P < .05) and child (P < .001) phantoms compared to the respective panoramic and lateral cephalometric radiographs combined. Image quality analysis was not possible with radiation equivalent phantoms.

CONCLUSIONS

Unlike standard CBCTs, shielded low-dose CBCT protocols in the CS 9300 have lower effective doses than conventional radiographs for adult and child phantoms. If high resolution and cranial base visualization are necessary, combining a shielded LFOV standard exposure with a cephalometric radiograph is recommended.

Reproducibility of Natural Head Position assessed with stereophotogrammetry

OBJECTIVE

The aim of this study was to assess the stability of Natural Head Position (NHP) over time using the 3dMDface System.

SETTING AND SAMPLE POPULATION

This was an experimental study. Three-dimensional facial images of 40 students were captured on two different occasions, with an interval of at least two weeks.

MATERIALS AND METHODS

The images were taken using a stereophotogrammetric device (3dMD). The mirror positioned NHP was obtained in a standing position and then replicated in a sitting position for capturing. The self-balanced NHP was taken in a sitting position. Rapidform 3D software was used for position angle calculations. The angle changes between the positions were calculated for rotations around the x-, y- and z-axes.

RESULTS

The differences between NHP in the self-balanced and mirror positions recorded on the first and second occasions were 2.43 and 1.75 degrees, respectively, around the x-axis. The average changes in NHP around the x-axis between the self-balanced and mirror balanced positions exceeded 3 degrees at the two-week interval. The differences were smaller for the rotations around the y- and z-axes. Some subjects consistently tended to hold their heads in a more extended position when self-balanced, while others did this when mirror balanced. There was no difference in the reproducibility of NHP between men and women.

CONCLUSION

The reproducibility of NHP for consecutive stereophotogrammetric captures is generally acceptable. The reproducibility of NHP using the mirror position was slightly better compared with NHP in the sitting self-balanced position.